News article
A key paper released today outlines the need for a comprehensive work programme to address issues in primary and community healthcare, including funding, structure, workforce, the prevention and management of chronic conditions, and better enabling Māori to design and deliver whānau-centred primary and community healthcare.
Cabinet has approved the paper, ‘Achieving pae ora through primary and community healthcare’, which sets out the vision for primary and community healthcare over the next 10 years and the key areas that health agencies will be focusing on. Read the Achieving Pae Ora Through Primary Care cabinet paper.
Manatū Hauora – Ministry of Health, Te Whatu Ora – Health New Zealand and Te Aka Whai Ora – Māori Health Authority will be working together to identify the changes and investments needed to make sure all New Zealanders can access high quality healthcare in their local communities.
This work builds on the six Pae Ora | Healthy Future strategies, published in July, which set the direction for a system that is equitable, accessible, cohesive and people-centred. During the development of those strategies, public engagement highlighted how important primary and community healthcare was to people’s health and wellbeing.
It also follows the Health Workforce Plan 2023/24 developed by Te Whatu Ora and Te Aka Whai Ora, which includes many primary and community healthcare initiatives.
Primary and community healthcare covers a broad range of health services and plays a key role in preventing illness, providing early intervention and reducing the impact of long-term conditions. These services are critical to reducing pressure on hospitals and other health services.
Manatū Hauora’s Chief Medical Officer Dr Joe Bourne says the primary and community workforce has identified fundamental issues with the sector that need addressing.
“This work programme offers an opportunity to redesign primary and community healthcare to take advantage of the health outcome benefits that it can deliver. We have heard the issues being raised by communities and healthcare workers that impact on access to care.
“We will be reviewing the structure of the system, how the knowledge and expertise of the workforce can focus on prevention as well as supporting people with complex chronic conditions, ensuring that investment and funding drive improved outcomes and equity for Māori.
“The transformation required will take time, but we will also continue to make improvements in the short-term, working with Te Whatu Ora and Te Aka Whai Ora through Te Pae Tata, the Interim New Zealand Health Plan.”
Abbe Anderson, National Director, Commissioning at Te Whatu Ora says: "Te Whatu Ora is pleased to be involved in this work programme, which is designed to recognise and build on the great strengths of primary and community healthcare.
“We know both the workforce and people accessing healthcare have been grappling with a range of challenges. We will continue to work alongside the sector toward our shared aim of providing better health outcomes for all New Zealanders.”
Dr Rawiri McKree Jansen, Chief Medical Officer at Te Aka Whai Ora, says: "Stage one of the Waitangi Tribunal Health Services and Outcomes inquiry showed that the health system has failed to look after Māori. This work provides us with a chance to change this picture and to ensure whānau, hapū, iwi and hāpori can access high quality healthcare in their local communities, leading to better health outcomes.”
“We can be bold and work to create a primary and community healthcare system that is culturally safe and appropriate, and whānau-centred to promote health and wellbeing, prevent illness and harm throughout people’s lives,” Dr McKree Jansen says.
The Cabinet paper highlights the need to provide equitable healthcare to Māori — healthcare that is accessible, culturally safe and appropriate, and whānau-centred to promote health and wellbeing.
The health reforms introduced by the Pae Ora Act strengthened the Crown’s commitment to Te Tiriti o Waitangi. The Act specifies that the health sector needs to engage with Māori to develop solutions that improve hauora Māori outcomes; to ensure equitable healthcare access and outcomes; to focus on prevention, health protection and promotion through a population health approach; and to engage with Māori to develop and deliver services that reflect their needs and aspirations.
The paper also outlines the role of localities in primary and community healthcare and the wider health system. Localities are a new feature of the health system and are designed to better connect service providers, iwi and other stakeholders to collectively improve community health and wellbeing outcomes. Te Whatu Ora and Te Aka Whai Ora are working with 12 prototype localities to test the approach. By July 2024, locality boundaries will be determined for all parts of Aotearoa New Zealand.
The primary and community healthcare work programme will take place throughout late 2023 and 2024. Health agencies will be engaging across the primary and community healthcare sector, with the social sector and with users of health services about what is needed to achieve the vision.
For more information about this work, see the Primary and community healthcare section.